• Bharti AXA Smart Critical Illness Insurance Plan

    Health Insurance
    • Enjoy options to cover yourself, your spouse, kids and even your parents
    • Enjoy access to 10,000+ hospitals for cashless treatment
    • Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

    With the changing lifestyle and environmental conditions, the threat of critical illness has increased multiple times in the recent days. It goes without saying that adequate insurance coverage is essential to protect oneself from various unexpected medical threats. Bharti AXA Smart Critical Illness Insurance Plan is a critical illness cover that can act as a supplemental cover in addition to a base health insurance plan. Unlike most critical illness policies, this coverage is available as either fixed-benefit plan or indemnity-based plan based on the requirement of the policyholder.

    Eligibility for Bharti AXA Smart Critical Illness Insurance Plan

    The following eligibility criteria applies to Bharti AXA Smart Critical Illness Insurance Plan:

    • The age of the proposer must be at least 18 years.
    • The maximum entry age of the policyholder is capped at 55 years.
    • Dependents can be covered from the age of 3 months.
    • For children between the age of 3 months and 5 years, at least one of the parent must be enrolled alongside in order to avail this cover.
    • This cover can also be taken on a family floater basis. Family floater coverage is available for self, spouse, and up to 2 dependent children.
    • Lifelong renewability option is available under this policy once the entry age criteria is satisfied.

    Features of Bharti AXA Smart Critical Illness Insurance Plan

    Some of the notable features of Bharti AXA Smart Critical Illness Insurance Plan can be given as follows:

    • This policy is available in 3 different sum insured options: Rs.2 lakh, Rs.3 lakh, and Rs.5 lakh.
    • Policyholders can choose between reimbursement of hospitalisation expenses benefit or fixed-benefit lump sum payment.
    • The fixed-benefit lump sum compensation will be paid after a survival period of 30 days. In other words, the insured must survive for at least 30 days following the first diagnosis of the critical illness in order to get the sum insured benefit.
    • This coverage is available for up to 20 critical illnesses.
    • Pre-existing illnesses are covered only after 4 continuous renewals from the date of inception of the policy.
    • Any critical illness diagnosed within the first 60 days of the policy cover will not be covered under this policy. This waiting period is not applicable for subsequent renewals.
    • Pre policy medical examination is necessary for people with pre-existing conditions or those entering this cover after 45 years of age. Following successful acceptance of the proposal, the company will reimburse 50% of the medical examination costs.
    • The sum insured amount chosen at the time of enrollment can be increased at the time of renewal on condition that no prior claims have been made under this policy.
    • Policyholders have a grace period of 30 days from the date of expiry for renewing this policy cover.
    • The first 15-day free look period can be used to review the terms and conditions of the policy. During this period, the policy can be cancelled without incurring any premium costs.
    • As per the IRDAI guidelines, policyholders have the option of migrating their policies to other insurers without losing out on any accrued benefits. In this case, the company must be notified at least 45 days before the date of renewal.
    • According to Section 80D of the Income Tax Act, the premium amount paid for this policy is eligible for tax relief.

    List of Critical Illnesses Covered

    Bharti AXA Smart Critical Illness Insurance Plan provides coverage against the following 20 critical illnesses:

    1. Stroke
    2. Coma
    3. Kidney Failure
    4. Bacterial Meningitis
    5. Cancer
    6. Multiple Sclerosis
    7. Major Burns
    8. Terminal Illness
    9. Organ/Bone Marrow Transplant
    10. Fulminant Hepatitis
    11. First Heart Attack
    12. Primary Pulmonary Hypertension
    13. Motor Neuron Disease
    14. End Stage Liver Failure
    15. Aplastic Anaemia
    16. Surgery to Aorta
    17. End Stage Lung Disease
    18. Coronary Artery Bypass Surgery
    19. Heart Valve Surgery
    20. Coronary Artery Disease

    Benefits of Bharti AXA Smart Critical Illness Insurance Plan

    The range of benefits available under this critical illness policy can be given as follows:

    Benefits Extent of Coverage
    First diagnosis of a named critical illness Indemnity benefit up to the sum insured limit against hospitalisation expenses [or] Lump sum payment of the full sum insured amount upon completion of the survival period of 30 days
    Pre-hospitalisation medical expenses Up to the sum insured limit
    Post hospitalisation medical expenses Up to the sum insured limit
    Dread disease recuperation benefit Rs.500 per day subject to a maximum of 45 days per policy year
    Hospital cash allowance (maximum of 30 days) Rs.750 per day for sum insured Rs.2 lakh Rs.1,000 per day for sum insured Rs.3 lakh and Rs.5 lakh (available after a deductible of 3 days)
    Ambulance charges Actual expenses subject to a maximum of Rs.2,500
    Home nursing cover (maximum of 10 days after a 3-day deductible) Rs.350 per day for sum insured Rs.2 lakh Rs.500 per day for sum insured Rs.3 lakh and Rs.5 lakh
    Inpatient physiotherapy Up to 2% of the sum insured amount
    Accompanying person expenses (maximum of 10 days after a 3-day deductible) Rs.250 per day
    Children education benefit Rs.5,000
    Carriage of mortal remains Rs.1,000 for sum insured Rs.2 lakh Rs.2,000 for sum insured Rs.3 lakh and Rs.5 lakh
    Renewal discount 5% of the sum insured per claim-free year subject to a maximum of 25% of the sum insured amount

    Exclusions of Bharti AXA Smart Critical Illness Insurance Plan

    The following list of exclusions will not be covered by this policy:

    • Treatment arising out participation in criminal activities
    • Claims resulting from abuse of drugs or alcohol
    • Medical expenses related to intentional self-injury or suicide attempt
    • Any kind of experimental or unproven treatment
    • Expenses related to cataract and laser surgery
    • Claims related to sexually transmitted diseases or venereal diseases
    • Medical expenses related to pregnancy and childbirth
    • Cost of aesthetic or cosmetic treatments
    • Expenses related to treatment for psychiatric or mental illnesses
    • Congenital diseases, birth defects, and anomalies
    • Non-medical expenses incurred during the time of hospital stay

    Claim Procedure

    The claim settlement process is managed with the help of third-party administrators (TPAs). Cashless treatment facility is offered through the 4,300+ network hospitals located in different parts of the country. Following the diagnosis of any of the named critical illness, the TPA must be notified immediately. The TPA might require all the bills and documents necessary to support the claim.

    Along with the claim form, the insured must submit bills, medical reports, diagnostic reports, prescriptions, etc. to the TPA. Once the documents are submitted, the TPA will verify the validity of the request and approve/reject the claim. The company promises claim settlement within a maximum of 21 days from the date of receipt of all required documents.

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